Topic: Case Study ( From a Nurse Practitioner point)
Patient is a 68-year-old female with PMH of HTN, hypothyroidism, and DM II who presents to the ED with a 2-day history of “achy” left lower quadrant abdominal pain, 9/10 on pain scale, low-grade fever and nausea that started about 12 hours ago.
Her last colonoscopy was 2 years ago, findings were normal.
Physical examination: T 101.6°F. Bowel sounds are hypoactive. There is generalized tenderness with guarding in the left lower quadrant. Her stool is negative for occult blood. KUB shows distended loops of bowel + gas patterns, and a moderate rectal fecal mass, but no evidence of free air. She is started on intravenous fluids and a BM protocol with minimal improvement in her symptoms.
Discuss the following:
Give 3-5 Differential Diagnoses for this patient
What further testing would you perform to obtain your “working” diagnosis?
What is your final “working” diagnosis with a complete Management plan
What alternative or complementary techniques may benefit this patient both in acute care and for future prevention?
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